Abstracts

Rationale:
Current literature describes an association between epilepsy and autism spectrum disorder (ASD), with a diagnosis of one condition augmenting the probability of developing the other.¹ Both epilepsy and ASD are complex conditions that require frequent appointments and medical support. We aim to assess the difference in quality of life (QOL) of patients and their caregivers with comorbid epilepsy and ASD versus epilepsy alone.




Methods:
We conducted a retrospective cohort study at Dayton Children’s Hospital of patients aged 2-17 years with a diagnosis of either epilepsy and ASD or epilepsy alone from 01/2022 to 02/2023. Variables abstracted included demographics and information regarding diagnosis and management of epilepsy and ASD. Primary caregivers were prospectively invited to participate and complete 3 surveys regarding the patient’s and their quality of life (QOL in childhood epilepsy questionnaire (QOLCE-55), Care-related QOL (CarerQol-7D) and Health-Related Social Needs screening (HRSN)).




Results:
115 patients, 83 with epilepsy only and 32 with epilepsy and ASD were included. The majority were male 61.7%, with a mean age of 3.9 years. Most patients were white (82.6%), not Hispanic (94.8%), covered by Medicaid (59.1%) and from a two-parent household (58.3%). A total of 43 surveys were completed by caregivers (21 epilepsy only and 22 ASD and epilepsy). A significant difference was noted in the total mean QOLCE-55 score between epilepsy only (67.7) and epilepsy and ASD (48.4) groups (Table 1). The cognitive, emotional and functioning sub-sections of the QOLCE-55 were significantly different between the groups. A significant difference was also noted in the total mean CarerQol-7D score between epilepsy only (80.3) and epilepsy and ASD (68.8) groups. No differences were seen in the HRSN.




Conclusions:
Patients QOL, as assessed by their caregivers in the QOLCE-55, was noted to be 19.3 points higher in those with epilepsy only versus patients with epilepsy and comorbid ASD, indicating a better QOL. The sub-categories of the QOLCE-55 that were significantly lower for those with comorbid ASD and epilepsy included emotional and cognitive functioning indicating the need for additional support in patients with comorbid epilepsy and ASD. Caregiver QOL was noted to be 11.5 points lower in in those with epilepsy and autism, indicating that additional support may be needed for caregivers of patients with comorbid ASD and epilepsy.



References:

1. Strasser L, Downes M, Kung J, Cross JH, De Haan M. Prevalence and risk factors for autism spectrum disorder in epilepsy: a systematic review and meta-analysis. Developmental Medicine & Child Neurology. 2017;60(1):19-29. doi:https://doi.org/10.1111/dmcn.13598




Funding:
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.